Skip to main content

Advertisement

Log in

Skin donors and human skin allografts: evaluation of an 11-year practice and discard in a referral tissue bank

  • Original Paper
  • Published:
Cell and Tissue Banking Aims and scope Submit manuscript

Abstract

The Saint Louis hospital tissue bank provides skin allografts to pediatric and adult burn units in the Paris area. The aim of this study was to analyze our activity during the last 11 years focusing on the reasons for skin discard. Skin is procured solely from the back of the body, which is divided into 10 zones that are harvested and processed separately. This retrospective study included all skin donors harvested between June 2002 and June 2013, representing a total of 336 donors and 2770 zones. The donors were multiorgan heart-beating donors in 91 % of cases (n = 307). The main reason for discarding harvested skin was microbial contamination, detected in 99 donors (29 %). Most contaminants were of low pathogenicity. Other reasons for discard included positive serologic tests for 2 donors [17 zones (0.61 %)], unsuitable physical skin characteristics for 3 zones (0.11 %), the donor’s medical history for 53 zones (1.91 %), and technical issues with processing or distribution for 61 zones (2.2 %). In our experience, microbial contamination continues to be the main reason for discarding potential skin allografts. However, discards are limited by separate harvesting and processing of multiple zones in each donor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Abbreviations

MOHBDs:

Multi-organ heart-beating donors

NHBDs:

Non-heart-beating donors

References

  • Achermann Y, Goldstein EJC, Coenye T, Shirtliff ME (2014) Propionibacterium acnes: from commensal to opportunistic biofilm-associated implant pathogen. Clin Microbiol Rev 27:419–440

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Agence de la biomédecine (2012). Annual report

  • Beele H, van Wijk MJ, Parker R, Sánchez-Ibáňez J, Brubaker SA, Wulff B, Richters CD, Cox M, Warwick RM, Eastlund T (2013) Report of the clinical donor case workshop of the European Association of Tissue Banks annual meeting 2012. Cell Tissue Bank 14:561–570

    Article  PubMed  Google Scholar 

  • De Backere AC (1994) Euro Skin Bank: large scale skin-banking in Europe based on glycerol-preservation of donor skin. Burns J Int Soc Burn Inj 20(Suppl 1):S4–S9

    Article  Google Scholar 

  • Deijkers RL, Bloem RM, Petit PL, Brand R, Vehmeyer SB, Veen MR (1997) Contamination of bone allografts: analysis of incidence and predisposing factors. J Bone Joint Surg Br 79:161–166

    Article  CAS  PubMed  Google Scholar 

  • Forsell JH, Liesman J (2000) Analysis of potential causes of positive microbiological cultures in tissue donors. Cell Tissue Bank 1:111–115

    Article  PubMed  Google Scholar 

  • Gaucher S, Elie C, Vérola O, Jarraya M (2012) Viability of cryopreserved human skin allografts: effects of transport media and cryoprotectant. Cell Tissue Bank 13:147–155

    Article  CAS  PubMed  Google Scholar 

  • Gaucher S, Duchange N, Jarraya M, Magne J, Rochet J-M, Stéphanazzi J, Hervé C, Moutel G (2013) Severe adult burn survivors. What information about skin allografts? Cell Tissue Bank 14:505–510

    Article  PubMed  Google Scholar 

  • Ireland L, Spelman D (2005) Bacterial contamination of tissue allografts—experiences of the donor tissue bank of Victoria. Cell Tissue Bank 6:181–189

    Article  PubMed  Google Scholar 

  • Kearney JN (2005) Guidelines on processing and clinical use of skin allografts. Clin Dermatol 23:357–364

    Article  PubMed  Google Scholar 

  • Kobayashi H, Oethinger M, Tuohy MJ, Procop GW, Bauer TW (2009) Improved detection of biofilm-formative bacteria by vortexing and sonication: a pilot study. Clin Orthop 467:1360–1364

    Article  PubMed  PubMed Central  Google Scholar 

  • Lannau B, Van Geyt C, Van Maele G, Beele H (2015) Analysis of potential factors affecting microbiological cultures in tissue donors during procurement. Cell Tissue Bank 16:65–71

  • Lindford AJ, Frey I, Vuola J, Koljonen V (2010) Evolving practice of the Helsinki Skin Bank. Int Wound J 7:277–281

    Article  PubMed  Google Scholar 

  • Lomas RJ, Huang Q, Pegg DE, Kearney JN (2004) Application of a high-level peracetic acid disinfection protocol to re-process antibiotic disinfected skin allografts. Cell Tissue Bank 5:23–36

    Article  CAS  PubMed  Google Scholar 

  • Mathur M, De A, Gore M (2009) Microbiological assessment of cadaver skin grafts received in a Skin Bank. Burns J Int Soc Burn Inj 35:104–106

    Article  Google Scholar 

  • May SR, Wainwright JF, DeClement FA (1985) Variables determining the amount of microbial contamination on cadaveric allograft skin used as a biological wound dressing. Burns Incl Therm Inj 11:242–251

    Article  CAS  PubMed  Google Scholar 

  • May SR, Roberts DP, DeClement FA, Still JM (1991) Reduced bacteria on transplantable allograft skin after preparation with chlorhexidine gluconate, povidone-iodine, and isopropanol. J Burn Care Rehabil 12:224–228

    Article  CAS  PubMed  Google Scholar 

  • Neely AN, Plessinger RT, Stamper B, Kagan RJ (2008) Can contamination of a patient’s allograft be traced back to the allograft donor? J Burn Care Res: Off Publ Am Burn Assoc 29:73–76

    Google Scholar 

  • Obeng MK, McCauley RL, Barnett JR, Heggers JP, Sheridan K, Schutzler SS (2001) Cadaveric allograft discards as a result of positive skin cultures. Burns J Int Soc Burn Inj 27:267–271

    Article  CAS  Google Scholar 

  • Pianigiani E, Risulo M, Ierardi F, Sbano P, Andreassi L, Fimiani M, Caudai C, Valensin PE, Zazzi M (2006) Prevalence of skin allograft discards as a result of serological and molecular microbiological screening in a regional skin bank in Italy. Burns J Int. Soc Burn Inj 32:348–351

    Article  Google Scholar 

  • Pianigiani E, Ierardi F, Cuciti C, Brignali S, Oggioni M, Fimiani M (2010) Processing efficacy in relation to microbial contamination of skin allografts from 723 donors. Burns J Int Soc Burn Inj 36:347–351

    Article  CAS  Google Scholar 

  • Pirnay J-P, Verween G, Pascual B, Verbeken G, De Corte P, Rose T, Jennes S, Vanderkelen A, Marichal M, Heuninckx W et al (2012) Evaluation of a microbiological screening and acceptance procedure for cryopreserved skin allografts based on 14 day cultures. Cell Tissue Bank 13:287–295

    Article  PubMed  PubMed Central  Google Scholar 

  • Pitt TL, Tidey K, Roy A, Ancliff S, Lomas R, McDonald CP (2014) Activity of four antimicrobial cocktails for tissue allograft decontamination against bacteria and Candida spp. of known susceptibility at different temperatures. Cell Tissue Bank 15:119–125

    Article  CAS  PubMed  Google Scholar 

  • Portillo ME, Salvadó M, Alier A, Martínez S, Sorli L, Horcajada JP, Puig L (2014) Advantages of sonication fluid culture for the diagnosis of prosthetic joint infection. J Infect 69:35–41

    Article  PubMed  Google Scholar 

  • Schubert T, Bigaré E, Van Isacker T, Gigi J, Delloye C, Cornu O (2012) Analysis of predisposing factors for contamination of bone and tendon allografts. Cell Tissue Bank 13:421–429

    Article  PubMed  Google Scholar 

  • Shin K, Yun Y, Yi S, Lee HG, Cho J-C, Suh K-D, Lee J, Park J (2013) Biofilm-forming ability of Staphylococcus aureus strains isolated from human skin. J Dermatol Sci 71:130–137

    Article  CAS  PubMed  Google Scholar 

  • Singh S, Blevins M-B, Wakeman M, Bergevin M (2012) The utility of recovery biopsies in determining donor suitability. Cell Tissue Bank 13:565–567

    Article  PubMed  Google Scholar 

  • Van Geyt C, Van Wijk M, Bokhorst A, Beele H (2010) Physical examination of the potential tissue donor, what do European tissue banks do? Clin Transplant 24:259–264

    Article  PubMed  Google Scholar 

  • Vehmeyer S, Wolkenfelt J, Deijkers R, Petit P, Brand R, Bloem R (2002) Bacterial contamination in postmortem bone donors. Acta Orthop Scand 73:678–683

    Article  PubMed  Google Scholar 

  • Verbeken G, Verween G, De Vos D, Pascual B, De Corte P, Richters C, De Coninck A, Roseeuw D, Ectors N, Rose T et al (2012) Glycerol treatment as recovery procedure for cryopreserved human skin allografts positive for bacteria and fungi. Cell Tissue Bank 13:1–7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors would like to thanks Dr. Jean-Luc Donay from the microbiology department of Saint Louis Hospital as well as Thierry Marchix, Chantal Schaffart, and all the members of the Tissue Bank technical team. Thanks to Dr. Sophie Olson for revising this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mohamed Jarraya.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Additional information

Sonia Gaucher and Zena Khaznadar have contributed equally to this work.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gaucher, S., Khaznadar, Z., Gourevitch, JC. et al. Skin donors and human skin allografts: evaluation of an 11-year practice and discard in a referral tissue bank. Cell Tissue Bank 17, 11–19 (2016). https://doi.org/10.1007/s10561-015-9528-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10561-015-9528-3

Keywords

Navigation